4320 children aged, 0-59 months, were
measured
(Weight,
Height
and
Mid
Upper
Arm Circumference) in 31 villages
in the
district
of
Mbarara
(Southwest
Uganda)
in March and April 1988. Socioeconomic and
health
characteristics
of the
families of the children were also collected.
The socioeconomic variables were analysed through
Multiple
Correspondence
Analysis which produced 7 socioeconomic
classes.
These
were
reduced
to
3
socioeconomic groups (SEGs) because of
similarities
between
some
of the
classes. SEG I was the most advantaged group with
a
higher level
of
education, a high prevalence of Government workers
and professionals
who
were
able to hire labour. SEG II was mainly composed
of cattle
keepers
and
producers of export crops with only primary
education,
not
hiring labour
and
not working on other people's land. SEG III
was
the
most
disadvantaged
group
with minimal or no education and mainly comprised
of
subsistence
farmers
frequently working on other people's
land.
SEG I
was
the
best
off
in
every
socioeconomic, health and nutrition
indicator,
while
SEG III
was the
worst
off.
After 12 months, a follow-up survey was carried
out
in
order to
assess
the
number of children who had died.
Mortality rates were inversely proportional to
anthropometric
indices.
There
was no interaction between mortality associated
with
different
anthropometric
cut-off points and SEGs. Malnutrition produced
similar
mortality
across the
SEGs. The most sensitive predictor
for
mortality
was
Mid
Upper
Arm
Circumference and the weakest was
Weight for
Height.
Malnourished
children had a significantly higher risk of
death from fever,
measles,
diarrhoea,
acute
respiratory infections and malnutrition
while
there
was
no evidence
of
a
higher risk of death from other causes.
Ownership
of
cattle,
length
of stay
in the village, birth order, father's education
and
kind
of
lighting fuel
were
significantly associated with child mortality.
Nutritional status was influenced by socioeconomic
variables
directly
related
to the poverty conditions of the family, to
morbidity
(especially
diarrhoea),
and to hygienic conditions in the house.
Poverty was the main determinant of mortality
and malnutrition,
but
even
in
the better off sector of the community,
malnutrition
per
se put
children
at a
higher risk of death